ICD-10 R73.02 is officially defined as "Impaired glucose tolerance (oral)." code R73.02 is referenced in 2 tracked payer policy changes from Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code R73.02 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Independence Blue Cross expanded coverage for Teplizumab-mzwv (Tzield) to include pediatric patients aged 1 to <8 years with stage 2 type 1 diabetes, while maintaining non-coverage for patients aged 8-17 with stage 3 T1D (classified as experimental/investigational). Six ICD-10 diagnosis codes were removed from the policy. Billing teams must update systems to reflect the new pediatric age coverage expansion effective December 7, 2026.
This is a reissue with no substantive changes to the Tzield (teplizumab-mzwv) coverage policy. The policy was previously updated on 11/18/2024 to remove medical necessity criteria based on family history of type 1 diabetes; this 05/28/2025 reissue confirms those changes under the annual review process. Coverage remains limited to stage 2 type 1 diabetes in patients 8+ years old who meet specific autoantibody and glucose tolerance criteria, prescribed by an endocrinologist, with one lifetime treatment course of 14 doses.
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